Transtubal spread of serous adenocarcinoma of the endometrium: an underrecognized mechanism of metastasis

International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists
Matthew J SnyderStanley J Robboy

Abstract

Most endometrial carcinomas metastasize by invading myometrial lymphatics and spreading to regional lymph nodes. However, uterine serous carcinomas (USCs) metastasize frequently to peritoneal surfaces even when only minimally invasive. This study examines the methods of spread and the role of retrograde transtubal spread. Eighty-seven USCs treated by hysterectomy were identified. Primary peritoneal cases and cases with significant ovarian involvement were excluded. Eighty (92%) cases were pure serous, and the remainder had at least 25% serous histology. Fifty-four of 87 (62%) had extrauterine spread at hysterectomy, most commonly to peritoneal surfaces and sometimes to the pelvic lymph nodes. Twenty-six of 54 (48%) cases had no lymphatic/vascular (LV) invasion and 18/54 (33%) had no myometrial invasion. Eleven of these 54 (20%) patients with metastases lacked both myometrial and LV invasion, and the metastases involved the peritoneal surface more often than the lymph nodes (p<0.001). Three of the 11 cases had tumor clusters in the fallopian tube lumen. Another 13 cases also had clusters of tumor within the fallopian tube lumen, and all 16 cases had peritoneal spread (p<0.001). Extrauterine spread correlated highly with LV invas...Continue Reading

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Citations

Jun 2, 2009·International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists·Elke A JarboeMarisa R Nucci
Apr 22, 2010·International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists·Colin J R StewartSukeerat Ruba
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